FDA Adverse Event
Injury
Summary report: N
CURITY
MDR report key: 7910944
·
Received September 26, 2018
Report
- Report Number
- 8040459-2018-00073
- Event Type
- Injury
- Date Received
- September 26, 2018
- Date of Event
- September 4, 2018
- Report Date
- September 26, 2018
- Manufacturer
- KENDALL GAMMATRON, THAILAND
- Product Code
- BTR
- Adverse Event
- Yes
- Product Problem
- Yes
- Report Source
- Manufacturer report
- Reporter Location
- CH
- Reporter Occupation
- OTHER HEALTH CARE PROFESSIONAL
Narratives
Additional Manufacturer Narrative · 1
THIS PRODUCT IS NOT SOLD IN US AND IS 510(K) EXEMPT. THIS REPORT IS ASSOCIATED TO A SIMILAR PRODUCT SOLD IN THE US WITH 510(K) NUMBER K892432. IF INFORMATION IS PROVIDED IN THE FUTURE, A SUPPLEMENTAL REPORT WILL BE ISSUED.
Description of Event or Problem · 1
ACCORDING TO THE REPORTER, INTRA-OPERATIVELY, THE DEVICE¿S CUFF WAS DAMAGED. IT WAS REPORTED THAT THE PHYSICIAN INTUBATED THE PATIENT THROUGH NASAL TRACHEA; A THREE CONSECUTIVE NASAL INTUBATION WAS PERFORMED. IT WAS STATED THAT THE CUFF WAS LEAKING AND REQUIRED RE PLACEMENT. THE CUSTOMER REPORTED THAT THE PATIENT HAD MUCOSAL INJURY BLEEDING DUE TO THREE CONSECUTIVE NASAL INTUBATION, AND PHYSICIAN REQUIRED TO PERFORM ORAL INTUBATION AS AN ALTERNATIVE.
Devices
| Seq | Brand | Generic | Product Code | Manufacturer | Model | Lot | UDI-DI |
|---|---|---|---|---|---|---|---|
| 751268 | CURITY | TUBE, TRACHEAL (W/WO CONNECTOR) | BTR | KENDALL GAMMATRON, THAILAND | 9475E | 1627937FED |
Patients
| Seq | Age | Sex | Outcome | Treatment |
|---|---|---|---|---|
| 1 | 64 YR | Required Intervention |